Medicare

Medicare Open Enrollment: Five Things You Need to Do

November 30, 2015 • By

medicare 50th anniversary Routines help keep us focused, organized, and even healthy. However, if your health routine doesn’t include preparing for Medicare’s Open Enrollment, now’s the time to kick-start a new healthy habit.

If you have a Medicare health or prescription drug plan, you should review and compare coverage options. The Open Enrollment runs through December 7 and is the time you can make changes to your plan. Even if you’re happy with your current coverage, you might find a better fit for your budget or your health needs. If you miss an Open Enrollment deadline, you’ll most likely have to wait a full year before you can change your plan.

Here are five things every Medicare beneficiary can do to get in the Medicare Open Enrollment routine.

  1. Review your plan notice. Be sure to read any notices from your Medicare plan about changes for next year, especially your “Annual Notice of Change” letter. Look at your plan’s information to make sure your drugs are still covered and your doctors are still in network.
  1. Think about what matters most to you. Medicare health and drug plans change each year and so can your health needs. Do you need a new primary care doctor? Does your network include the specialist you want for an upcoming surgery? Does your current plan cover your new medications? Does another plan offer the same value at a lower cost? Take stock of your health status and determine if you need to make a change.
  1. Find out if you qualify for help paying for your Medicare. Learn about programs in your state to help with the costs of Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance and co-payments, and Medicare prescription drug coverage costs. Visit Medicare.gov or make an appointment with a local State Health Insurance Assistance Program (SHIP) counselor if you need help.
  1. Shop for plans that meet your needs and fit your budget. You can use the Medicare Plan Finder tool to see what other plans are offered in your area. A new plan may:
  • Cost less;
  • Cover your drugs costs; or
  • Let you use the providers you want, like your doctor or pharmacy.

If you find that your current coverage still meets your needs, then you don’t need to make any changes. Remember, during Medicare Open Enrollment, you can decide to stay in Original Medicare or join a Medicare Advantage Plan. If you’re already in a Medicare Advantage Plan, you can switch back to Original Medicare.

  1. Check your plan’s star rating before you enroll. The Medicare Plan Finder includes Star Ratings for the 2016 Medicare health and prescription drug plans. Plans are rated for quality on a one- to five-star scale: one star represents poor performance and five stars represent excellent performance. Be sure to use the ratings to compare the quality of any health and drug plans you are considering.

These are a few easy ways to get a jump-start on your Medicare Open Enrollment. For more information, call 1-800-MEDICARE (1-800-633-4227) and say “Agent.” TTY users should call 1-877-486-2048. Help is available 24 hours a day, including weekends. If you need help in a language other than English or Spanish, let the customer service representative know the language. You can also visit a local SHIP counselor. SHIP counselors provide free, one-on-one, non-biased Medicare assistance. Get free personalized health insurance counseling by calling your SHIP at the number listed on the Medicare contacts page or call 1-800-MEDICARE.

 


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Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

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  1. larraine whittington

    I will be turning 65 yo in March. I am still actively working and have health insurance through my employer. I plan to continue working for a few more years. Do I still need to “register” when I turn 65, even though I do NOT want to draw SS income and do NOT need to have Medicare–do I still need to apply?

    Reply
    • Vonda

      Thanks for your question, Larraine. If you are covered under a group health plan based on current employment, you may qualify for a Special Enrollment Period (SEP) that will let you sign up for Medicare Part B after age 65. You have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):
      • The month after the employment ends
      • The month after group health plan insurance based on current employment ends.

      Usually, you don’t pay a late enrollment penalty if you sign up during a SEP.

      You should always check with your health benefits advisor, or health plan representative to see what’s best for you. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. For further assistance, call your local Social Security office. Look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.

      Reply
  2. Mark Hanlon

    I need a “Notice of Medical Insurance Enrollment and Premium Deduction” form. Can you please send me mine? Thanks,
    Mark

    Reply
    • Vonda

      Hi Mark, thanks for using our blog. Check out our Frequently Asked Questions web page for details on how to get a benefit verification letter. This letter is sometimes called a budget letter, a benefits letter, a proof of income letter or a proof of award letter. You also may be able to request a benefit verification letter by using our automated telephone service at 1-800-772-1213. You can conduct the automated services 24 hours a day. At the prompt, indicate that you’re requesting a proof of income letter. We hope this helps.

      Reply
  3. Robert Gilmour

    I have moved to Canada and I wish to cancel my Medicare coverage. I contacted Medicare, but they said I needed to speak with Social Security. I have called the SSA number several times, but no one answers the call. Can you help me please? Thanks.

    Reply
    • Vonda

      Hi Robert, thanks for using our blog. Check out our Frequently Asked Questions web page for details on how to terminate Medicare Part B. We hope this helps!

      Reply

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